The CARDIAC Project has two types of screening methods: CARDIAC Kid (5th grade students) and CARDIAC Project: TOO (all other applicable grades as available). This page describes the purpose, design, procedures and confidentiality associated with each screening type.

CARDIAC Kid

Purpose

The purpose of this project is to learn more about heart disease risk factors in children as a means of determining which children and their parents are at risk of developing early or premature coronary artery disease. Early identification of and education about certain growth patterns will provide the-opportunity to work with families to reduce the risk of heart disease and other chronic health problems later in the child’s life. It is hoped that increased awareness of cardiovascular disease risk factors within the community will result in local strategies to promote wellness.

Design

This project is designed to provide a cardiovascular risk screening to children enrolled in fifth grade in West Virginia. All WV 5th graders are eligible for CARDIAC screenings each year. Parents of participating children are also given the opportunity to receive free fasting lipid profiles, which can be done a local laboratory. The county superintendent of schools will determine whether all schools in their county will participate, or alternatively that some might be excluded for logistical reasons. Superintendent support letters from all participating counties are on file in the Central CARDIAC office.

The CARDIAC Project now uses Area Coordinators (previously WVRHEP infrastructure)hired by the project to coordinate screenings in their respective areas. During the pilot project year,Year 1 – 1998—1999, three counties agreed to participate in the pilot screenings. Fifth grade students in Barbour, Boone and Lincoln counties were screened. Currently roughly 50 counties participate in screenings each.

Although the CARDIAC Project no longer uses the WVRHEP infrastructure as of year 13, interested health science students are still encouraged to assist in screenings. An instruction module describing proper conduct of the questionnaire, blood pressure and anthropometric measurement, has been prepared for all individuals engaged in this effort. Area coordinators document completion of the instruction module on all participants.

Procedures

Prior to screening day, 5th grade students are introduced to CARDIAC by teachers, school nurses, trained student nurses and other health science students, and CARDIAC area coordinators and are given the consent brochure.

The consent brochure consists of a letter detailing the Project and a brief demographic and family history questionnaire related to coronary heart disease, elevated blood cholesterol among first-degree relatives, diabetes, and tobacco use. Students for who consent and assent have been given participate in the CARDIAC Kid screening.

CARDIAC Kid screenings include a Fasting Lipid Profile (FLP), height, weight, blood pressure and a check for the Acanthosis Nigricans (AN) marker on the back of the neck. Separate stations (for confidentiality and privacy) are set up at the school for: registration, height, weight, AN check, and the FLP. The FLP requires obtaining approximately a teaspoon of blood from a vein in the arm using a small needle by a phlebotomist. If a child receives an FLP during screening, this qualifies the parents to have a fasting lipid profile at a local designated lab.

Following the screening, parents and the participating child receive a health report describing the results of the screening process. If the parent elected, the health report will also be mailed to the child’s physician.

Families may receive a survey to complete concerning their health behaviors.

Confidentiality

What information will be used or disclosed?

Height and weight will be used to calculate body mass index (BMI) and BMI percentile for each participant. Other information includes presence of Acanthosis Nigricans (AN), blood pressure and percentiles, and results from the FLP (cholesterol levels). This information will be returned to the family of the participating child and to the school nurse from that school for complete medical follow-up. If the parent elected, this information will also be mailed to the child’s physician.

Who will have access to, or use of, the health information?

CARDIAC staff and school nurse, and physician if requested by the parent

How will the health information be used or disclosed?

The health information is maintained in a password-protected system. A CARDIAC ID number is used for all correspondence and linkage purposes. Aggregate data by county for BMI categories is available annually on our website

CARDIAC Project: TOO

Design

This project is designed to provide a body mass index (BMI) screening to children enrolled in targeted grades upon approval by the superintendent of the school(s). Families have the opportunity to opt-out of this study by informing study or school personnel in writing of their request to not participate. The child may also opt-out at any time during screening procedures. Screening will consist of height and weight assessments. Screening staff will also look at the back of the children´s necks for Acanthosis Nigricans (AN), a dark pigmentation that, if present, could indicate insulin resistance. The height and weight information will be used to calculate the student´s BMI and BMI percentile. Screening results (via sealed health report) will be sent to children and their families. Parents whose children are identified as overweight or obese or have the AN marker on the back of their necks are asked to talk to their physicians/pediatrician about these risks and recommended lifestyle changes.

Procedures

1) Opt out letters furnished to school personnel for distribution at the beginning of the school year.
2) Screening day: Separate stations (for confidentiality and privacy) are set up at the school for: registration, height, weight, and AN check.
3) After screening day: Central office staff calculates BMI and BMI percentile based on students height and weight. A health report is generated, placed in a sealed envelope, sent to the school nurse to be sent home to the parents.

Confidentiality

What information will be used or disclosed?

Height and weight will be used to calculate body mass index (BMI) and BMI percentile for each participant, along with checks for Acanthosis Nigricans (AN). This information will be returned to the family of the participating child and to the school nurse from that school for complete medical follow-up.

Who will have access to, or use of, the health information?

CARDIAC staff and school nurse

How will the health information be used?

The health information is maintained in a password-protected system. A CARDIAC ID number is used for all correspondence and linkage purposes. Student BMI, BMI percentiles and AN will be included in the health report that goes to the families and school nurse following the screening.